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Will Prostate Cancer Treatment Cause Incontinence?

by David J. Cahn, M.D.

Loss of urinary control is a common fear for many men when facing prostate cancer treatment. For some men, urinary incontinence can be worse than experiencing erectile dysfunction. And it’s no wonder. After all, it affects your life every day. If you’re worried about urinary incontinence or are dealing with it already, here’s what you need to know.

What is Urinary Incontinence?

Urinary incontinence after a prostatectomy can present as anything from a dribble or slight leakage of urine when you sneeze or cough (called stress incontinence) to total leakage. After radiation therapy, men may have a combination of leakage and a need to urinate frequently. Loss of control over the release of your urine can be stressful and embarrassing.

Why Do Some Men Experience Urinary Incontinence Following Treatment for Prostate Cancer?

When you urinate, the muscles in the bladder wall contract while the muscles that surround the urethra – the tube that carries urine from the bladder out of the body – relax. A prostatectomy can weaken the sphincter muscle that opens and closes to release urine and can cause damage to the nerves that control urination. Radiation, on the other hand, can shrink the capacity of your bladder resulting in spasms, which is why the type of incontinence can be somewhat different (stress incontinence vs. urge incontinence).

Who’s at Risk for Urinary Incontinence?

A man’s risk for urinary incontinence varies depending on what type of prostate cancer treatment he undergoes. About 6 to 8 percent of men who have a complete (radical) prostatectomy experience some incontinence, while it affects 8 to 10 percent of men after radiation therapy.  It’s important to know that most often it is not a permanent problem. How long it takes to resolve can vary, so patience and open dialogue with your doctor are key to managing the symptoms.

“Most often, urinary incontinence after prostate cancer treatment is not a permanent problem.”
– David Cahn, M.D.

Can Urinary Incontinence be Treated Successfully?

If you’re in the minority of men for whom incontinence sticks around, don’t lose hope. Depending on what is causing your problem, there are many treatment options. Medications, bladder retraining, collagen injections, and procedures such as urethral sling surgery and artificial urinary sphincter can all help to restore normal urinary control.  The first step, though, is being willing to talk about it.

Learn more about prostate cancer and prostate cancer treatment or find a physician at Colorado Urology.

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